Showing 31 - 40 of 624 annotations tagged with the keyword "Power Relations"

Freud's Mistress

Kaufman, Jennifer; Mack, Karen

Last Updated: Jul-31-2015
Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Minna Bernays is the younger sister of Martha, Sigmund Freud's wife. Her own fiancé has died and by 1895, she is reduced to joining her sister’s family in Vienna because she has abandoned her position as a companion to a demanding, prejudiced aristocrat. The six Freud children love her, but she finds them exhausting and undisciplined. Obsessed with order, housework, and social standing, and possibly suffering from psychosomatic ailments, Martha is happy to leave the care of the children to Minna. She disapproves of her husband’s theories about sexual frustration as a cause of mental distress and refuses to discuss his ideas. Nevertheless, Martha is well aware that growing anti-semitism hampers her husband’s career, and she is eager for him to succeed: he could consider a conversion of convenience, like the composer Gustav Mahler.

Minna finds herself drawn to Sigmund for his intellect and his novel ideas. She is also attracted to him physically, and he to her. She resists the temptation, but he does not and actively pursues her, inducing her to try cocaine too. He justifies it - the sex and the drugs - as necessities for mental and physical well-being and he rejects the guilt that, he claims, so-called civilization would impose.

She tries to leave by finding another job as a ladies’ companion in Frankfurt, but he follows her there. They escape for an idyllic holiday to a hotel in Switzerland, then he brings her back to the family home. But his ardor cools and she is wounded, displaced by his enthusiasm for Wilhelm Fliess and Lou Andreas-Salomé.

Soon she discovers that she is pregnant, and Freud sends her away to a “spa” for an abortion, but at the last moment, she decides to keep her baby. Sadly she miscarries and returns to the Freud family with whom she remains for more than four decades until her death in 1941.

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Annotated by:
Schilling, Carol

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Carol Levine began a roiling odyssey as a caregiver when a car accident left her husband paralyzed and in need of 24-hour care. She regards her husband’s survival as “a testament to one of American medicine's major successes — saving the lives of trauma patients.” But once he returned to their home, Levine encountered a healthcare system that was fragmented, chaotic, and inequitable. Unprepared to address chronic care, it remained oblivious to her needs as her husband’s primary medical “provider,” as they would say. Written nine years after the accident and eight years into her care giving, Levine’s essay recounts the stress and isolation she experienced attempting to navigate that system, to perform unrelenting chores, and to sustain her employment. Her job was, after all, the source of her husband’s managed care insurance, which regularly managed to leave Levine with unpaid bills. Even her work in medical ethics and healthcare policy could not help her locate the assistance she needed to assure the well being of her husband or herself.  Or of other care-giving families.

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Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

This Side of Doctoring is an anthology published in 2002 about the experiences of women in medicine. While the essays span multiple centuries, most are from the past 50 years. They reflect on a multitude of stages in the authors’ personal and professional lives. In 344 pages divided into twelve sections, including "Early Pioneers," "Life in the Trenches," and "Mothering and Doctoring," the 146 authors recount - in excerpts from published memoirs, previously published and unpublished essays, poems and other writings, many of them composed solely for this collection - what it was then and what it was in 2002 to be a woman becoming a doctor in the U.S.. All but a handful of the authors are physicians or surgeons. There is a heavy representation from institutions on both coasts, especially the Northeast. Four men were invited to reflect on being married to physician wives. There is one anonymous essay concerning sexual harassment and a final essay from a mother and daughter, both physicians.   Beginning with the first American female physicians in the mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary Putnam Jacobi, the anthology proceeds through the phases of medical school, residency, early and mid-careers, up to reflections from older physicians on a life spent in medicine. Many of the authors have names well known in the medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass, Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a few. 

The essays and poems and letters have, as a partial listing, the following subjects: family influences in becoming a physician; professional friendships; marriage; children and their impact on a woman’s career in medicine; the decision not to have children; ill family members; illness as a physician; establishing one's sexuality as a physician; struggles with male physicians and their egos; mentors, both female and male; memorable patients (often terminal or dying); the life of a wife-physician, or mother-physician; the guilt and sacrifice that accompany such a dual life; the importance - and easy loss - of personal time or what internist Catherine Chang calls “self-care” (page 334).
  The anthology also touches on how women have changed the practice of medicine in various ways, prompted by the growing realization, as family practice physician Alison Moll puts it, "that I didn't have to practice in the traditional way" (page 185)  The authors write about the wisdom of setting limits; training or working part-time or sharing a position with another woman; and the constant face-off with decisions, especially those not normally confronting an American man becoming a doctor. 
One conclusion is evident before the reader is halfway through the book: there are many approaches to becoming a fulfilled female physician including finding one’s identity in the field.  Implicit in most of the essays and writings is the lament from obstetrician-gynecologist Gayle Shore Mayer: "Where is the self ? There are pieces of me everywhere", (page 275) recalling a similar cry from Virginia Woolf's Orlando, another essentially female soul trying to find what Richard Selzer has called "The Exact Location of the Soul".
 Several authors discover that female physicians have unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I am a better physician because I am a mother, and I know because of my experiences as a physician that I am a better mother.” (page 151) 

There are sections at the end devoted to a glossary for the lay reader, resources for women (as of 2002), and generous notes about the contributors (which section also serves as a useful index of each's contributions).

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Hurt Hawks

Jeffers, Robinson

Last Updated: Mar-22-2015
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

"Hurt Hawks" is a narrative poem about a wounded hawk in free verse of 27 lines divided by the poet into two parts. Part I, which is 17 lines long, describes the setting of the poem in third person. Part II is 10 lines long, written in first person, and comprises the resolution of the carefully constructed tension set up in Part I. Some critics feel that Part II is sufficiently different in style and focus that it was originally an altogether separate poem (see below). Succinct yet lyrical, elegaic yet harsh, Hurt Hawks is, like the hawk that is the center of the poem, fiercely and unrelentingly an advocate of the natural - as opposed to the civilized - world. Hawks held a special place in Jeffers' heart, whether it be this poem or the longer "Cawdor," "Give Your Heart to the Hawks" (the name of a 1933 collection of his poetry), or "Hawk Tower," the edifice that he built for his family in 1920 on Carmel Point in California.

Part I sets the stage for the action in Part II, an Ecce Homo stage where the Homo is an injured hawk living in and around the poet—who makes clear, however, that the hawk is not a prisoner, either in the poet's eyes or its own. The poem opens with:

The broken pillar of the wing jags from the clotted shoulder,
The wing trails like a banner in defeat,
No more to use the sky forever but live with famine
And pain a few days:

Midway through Part II, Jeffers notes that

We had fed him six weeks, I gave him freedom,
He wandered over the foreland hill and returned in the evening, asking for death,
Not like a beggar, still eyed with the old
Implacable arrogance.

This poem is arguably not only Jeffers' most famous poem but often the only one still taught, when Jeffers is taught at all, in undergraduate courses. One reason for the inclusion of this poem in the curriculum is the famous first line of Part II, "I'd sooner, except the penalties, kill a man than a hawk." Aside from its popularity and this rather striking sentiment, the poem has proved a fertile source of discussion amongst critics for other reasons. First is the striking shift in voice from Part I to Part II, leading some to state that this poem was welded together from two distinct poems. Secondly, the plural "Hawks" in the title is mysterious and unclear since there is only one hawk mentioned in the poem—or is there? One interpretation of the plural is that in fact Jeffers and his family harbored two hawks and only the second was killed. Tim Hunt feels the second injured hawk in the poem refers to the saddened, or emotionally hurt hawk, i.e., the poet of Part II.

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Sông I Sing

Phi, Bao

Last Updated: Mar-12-2015
Annotated by:
Aull, Felice

Primary Category: Literature / Poetry

Genre: Poetry

Summary:

Performance poet Bao Phi was born in Saigon; his parents emigrated to Minnesota, where he grew up and still lives. His poetry is rooted in Asian American immigrant experience, especially in Vietnamese American experiences, and speaks of racism, economic hardship, cultural difference, and the legacy of the Vietnam war. The collection is divided into four sections, each preceded by a quote from another (usually Asian American) writer. Four introductory poems set the tone for the poet's project of "refugeography" (from "You Bring Out the Vietnamese in Me", p. 9): recognition and celebration of the variety of Asian American lives, and anger at exploitation - both economic and cultural: "They box our geography / And sell it in bougie boutiques / Our culture quite profitable / But can somebody tell me / How our culture can be hip / And yet our people remain invisible?" ("For Us", p. 1)

In section 2 (The Nguyens) 14 poems highlight the lives of a variety of unrelated individuals and families across the US who have the same family name. "They are one story for every Viet body, one song for every voice that sings or otherwise" (p. 17). Many are angry and bitter. There is the Sacramento girl who grows up, makes good, and wants now to get even with the white boy who pushed her down and called her "gook" in ninth grade: "where is your wheat- haired crown now, / where is your Made- in- America tongue: / a slide of spit to take me back to where I came from / now that I am ready to show you / show you / where I come from" ("Vu Nguyen's Revenge", p. 20). There is the chef who had once worked in the kitchen of a restaurant where the waitstaff was white only: "let me tell you that the white people / can choke to death on their lychee martinis" ("Fusion", p. 24). Others are reflective - such as the soldier in Iraq who meditates, "let me not tear apart a people, a country, causing Iraqi food to / become the nouvelle cuisine in 25 years back home" ("Mercy", p. 29).

Some wrestle with generational misunderstanding: Dotty from Dallas whose mother "hid the food stamps by holding [her] hand out like a fan of shame at the checkout line" and later kicked her out of the family, accusing her of being a "Commie" (p. 45). There is tongue in cheek irony, such as in "The Nguyen Twins Find Adoration in the Poetry World" (p. 40), about two vastly different poets - Joan, who has an Anglo boyfriend, publishes in respected traditional literary journals, includes in her work Vietnamese sentences "she never fails to translate" and who won the "safe ethnic poet award"; and Jesus, whose poems are "system fascist overthrow racism working class" performed on Def Poetry Jam where he mispronounces all three of the only Vietnamese words he uses in his poetry.

Numerous poems in sections 3 and 4 address racism. "Reverse Racism" (p. 59) imagines the tables being turned on whites: schools that teach only Asian-American history and suspend any student who questions it; jobs that "stick white men in middle -management hell, then put them on a pedestal as an example of how whites can be successful", and "when white men form their own groups to protect themselves, I'll accuse them of being separatists and reverse racists". "Dear Senator McCain" (p. 65) begins with a quote from the year 2000 in which the senator (who had been imprisoned and tortured by the North Vietnamese during the Vietnam war) says, "I hate the gooks. I will hate them as long as I live." The poem issues a challenge: "I am that gook waiting in your nightmare jungle / that gook in front of you with 17 items in the 10 items or less lane at the supermarket / that gook born with a grenade in his head / that gook that got a better grade than you in shop class" and ends, "Senator / what's the difference / between an Asian /and a gook / to you".

Another poem ("8 [9]", p. 93) is based on the 2006 killing of a 19-year-old Hmong American by a white policeman in Minneapolis. There is despair ("For Colored Boys in Danger of Sudden Unexplained Nocturnal Death Syndrome and All the Rest for Whom Considering Suicide Is Not Enuf ", p. 82 ). There are also poems of self-awareness, for example, of the dichotomy of an earlier ghetto life and a later "fancy college" experience ("Called [An Open Letter to Myself]", p. 76); intra-ethnic suspicion and misunderstanding ("Everyday People", p. 99); energy and pride ("Yellowbrown Babies for the Revolution", p. 86).

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Summary:

Carol Levine's anthology of stories and poems about the intimate caregiving that takes place within families and among friends and lovers reminds us that the experience of illness reaches beyond clinicians and patients. It can also touch, enrich, and exasperate the lives of those who travel with patients into what Levine calls the land of limbo. This land oddly resembles the place where some Christian theologians believe lost souls wander indefinitely between heaven and hell. For Levine the limbo of familial caregiving is an unmapped territory. In it caregivers perform seemingly endless medical, social, and psychological labors without professional training and with feelings of isolation and uncertainty. Caregiving in this modern limbo, created by contemporary medicine's capacity to extend the lives of those with chronic conditions and terminal illnesses, has become, according to Levine, "a normative experience" (1).

By compiling this useful selection of well known and less familiar stories and poems, Levine increases the visibility of the experience of familial caregiving among works of literature about medicine. While illness literature is typically classified by disease or disability, Levine focuses instead on the relationships between caregivers and those being cared for. Her collection organizes the literature into five parts: Children of Aging Parents; Husbands and Wives; Parents and Sick Children; Relatives, Lovers, and Friends; and Paid Caregivers who assist families. The literature in each section tends nonetheless to represent particular conditions: dementias, including Alzheimer's disease, cancer, and frailty in the first two sections; childhood cancer, hyperactivity, and mental illness in the third; AIDS in the fourth. 

Probably the most familiar and powerful works include Rick Moody's "Whosoever: The Language of Mothers and Sons," Ethan Canin's "We Are Nighttime Travelers," Alice Munro's "The Bear Came over the Mountain" (the source for the film "Away from Her"), Lorrie Moore's "People Like That Are the Only People Here," and several poems: Mark Doty's "Atlantis" and selections by Donald Hall, Jane Kenyon, James Dickey, and Raymond Carver.

These and the less familiar works offer disparate responses from both caregivers and those they care for. The narrator of Tereze Gluck's "Oceanic Hotel, Nice" thinks "what a bad person I was to not even want to touch his feet. . . it made me shudder" (220). The wife in Ann Harleman's "Thoreau's Laundry" cannot place her husband with Multiple Sclerosis in a nursing home because "his presence, however diminished, was as necessary to her as breathing" (116). The caregiver in "Starter" by Amy Hanridge "didn't want to be the person people feel bad about" (180).  Several stories explore the limits of obligation. As is often the case, the son in Eugenia Collier's "The Caregiver" is sick himself, failing to schedule his own doctor's appointments and dying before his mother. Marjorie Kemper's witty, exuberant "God's Goodness" plays out an unexpected relationship between a dying teenage boy and his Chinese immigrant aide, while his parents remain in the background.

Carol Levine's brief introduction to the collection explains that she excluded excerpts from memoirs and selected only very recent literature, almost all from the past three decades. A Resources section at the end includes some introductory medical humanities resources and practical resources for caregivers.

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Annotated by:
Aull, Felice

Primary Category: Literature / Nonfiction

Genre: Criticism

Summary:

This is a compendium of original critical essays on a wide range of topics written by a diverse group of scholars of what has traditionally been called "medical humanities." The editors argue for a change of name to "health humanities," pointing out that "medical" has a narrow frame of reference - evoking primarily the point of view of physicians and their interaction with patients, as well as the institution of biomedicine. Such a focus may exclude the myriad allied individuals and communities who work with patients and their families. The editors quote Daniel Goldberg, who notes that the health humanities should have the primary goal of "health and human flourishing rather than  . .  the delivery of medical care" (quoted on page 7).

The three editors are innovative contemporary scholar-educators in the field of medical/health humanities. They advocate Megan Boler's "pedagogy of discomfort" (quoted on page 8) and wish to provide students and educators "an opportunity to examine critically the origins and nature of their personal beliefs and values, beliefs and values embedded in the curriculum and the learning environment, as well as institutional policies - all of which intersect" . . and influence quality of care (8). In their own work and in this Reader the editors favor an approach to health humanities education and research that "challenge[s] the hegemony of a biomedicine that contributes to disparities and the discrimination of persons who don't quite fit the codified and naturalized norms of health."

The book is divided into 12 parts, each comprising three or four chapters: Disease and Illness, Disability, Death and Dying, Patient-Professional Relationships, The Body, Gender and Sexuality, Race and Class, Aging, Mental Illness, Spirituality and Religion, Science and Technology, and Health Professions Education. At the end of each section there is "an imaginative or reflective piece" on the topic. A wide range of disciplines is represented, including disability studies, history, bioethics, philosophy, literature, media studies, law, and medicine. Some of the authors are well-known and have been practicing their profession for many years (for example, Arthur Frank, Sander Gilman, Anne Hudson Jones, Martha Montello, John Lantos) while others have entered the field more recently and are gaining increasing attention (for example, Rebecca Garden, Daniel Goldberg, Allan Peterkin, Sayantani DasGupta).

The Reader is well documented: there are footnotes at the end of most chapters, a references section of 50 pages, notes on contributors, and a 72-page index.

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Summary:

Soldier Girls is an exhaustively researched, intimate report by a journalist of the lives and deployments of three women in the Indiana National Guard, who, through serving together in Afghanistan, become friends. Each of the women joined the Guard prior to 9/11/2001, mostly for economic reasons. Thorpe selected women who were vastly different in age and background.  Debbie Helton becomes a grandmother during deployment and has served in the guard for decades - she is eager to be deployed. Michelle Fischer (a pseudonym) is newly out of high school, has liberal political views and sees the Guard as a way to pay college tuition. Desma Brooks is a single mother of three with a fractured and unreliable support system. All three have alcohol and or drug dependency issues. Brooks and Helton are deployed a second time - to Iraq.

 As one of the women, Fischer, notes, the Bush wars were an ‘economic draft' (p. 374) The struggles to find adequate housing, reliable partners, good schools, decent jobs, and to avoid the morass of drug dealing, which particularly surround Fischer and Brooks, are paramount in their lives.   

The women bond not only due to their shared gender, but also due to their mutual sense of humor. For example, to distinguish her tent from the dozens of similar ones on the base in Afghanistan, Brooks orders 50 plastic pink flamingos to decorate the ‘lawn.'   

In Afghanistan, the women are part of the support troops, doing such jobs as fixing AK-47s for the Afghan National Army. Nonetheless, even there, they are in harm's way, with the potential for injury or death from mortars, buried bombs (landmines) and improvised explosive devices (IEDs). In Iraq, Brooks is exposed to danger daily, as she drives an armored vehicle  usually in the navigation spot of a long convoy, third in line. She suffers traumatic brain injury after driving too close to and detonating a large IED.    

Thorpe weaves the three stories together of the women into a seamless whole. She chooses to follow the post-deployment lives of the women, and it is after demobilization that the heartaches truly develop. For example, Helton, who had always been upbeat and extraordinarily generous with her nurturing, turns inward and suffers depression. Fischer finds it difficult to relate to anyone without a military background, yet feels alienated from veterans who continue with a gung-ho attitude. And Brooks's children, who felt abandoned by their mother, act out in different and difficult ways.   

Issues of military sexual trauma are introduced, though none of the main characters experiences MST. However, all are harassed, to varying degrees. Sexuality is a prominent theme, both heterosexual and homosexual. "Don't ask, don't tell" was the policy during their deployments. Partners during deployment are different than those at home, and infidelity is common on base, further dividing military from civilian life.   

A particularly poignant side-story is that of the translator, Abkar Khan, introduced on page 171: "He was movie-star handsome, with a square jaw, high cheekbones, chiseled lips, and an aquiline nose." Abkar accomplished what no amount of cultural sensitivity training might - he gave a face and voice to the people the troops had been sent to help: soldiers would later relate "that getting to know Abkar was the single greatest thing that would happen to them in Afghanistan - he was what gave meaning to their deployment". (p. 172) Abkar marries his first cousin in an arranged marriage, temporarily realizes his dream to work in the United States, then returns for a lucrative but dangerous job of translating in interrogations.   

Posttraumatic stress disorder, post deployment risky behavior, traumatic brain injury, and bone and joint injury due to maneuvers required while wearing heavy equipment and protective clothing are discussed. Despite the large numbers of sexual partners, no sexually transmitted diseases are discussed, but one minor character does get an abortion after a relationship with a superior officer (these relationships, though forbidden, seem common). As noted in the book, the costs of the wars in Iraq and Afghanistan go far beyond the activities in the war theaters themselves, but continue on in the lives of the returned troops, and the families of all those who were deployed.       

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Polio: An American Story

Oshinsky, David

Last Updated: Sep-16-2014
Annotated by:
Willms, Janice

Primary Category: Literature / Nonfiction

Genre: History

Summary:

 In his introduction, the author summarizes the history of polio’s first appearance as an epidemic in the United States, the ensuing research, subsequent applications of new information, attempts at abatement and ultimate success in the development of preventative measures.

Embedded in the successes and failures of the research applications are the details of human interactions.  Their impact on the goal of achieving near extinction of polio in America constitutes a dramatic subplot, which the historian adroitly weaves into the work.

For the reader who has only a sketchy knowledge of this important period in medical research, this history provides details of human exchanges, conflicts and resolutions necessary to bring the scientific developments to fruition.  Central among the multiple struggles rests the basic disagreement between Jonas Salk and Albert Sabin, two of the most prominent scientists working against the clock to develop the most effective and safest form of immunization.  Each new surge of the disease added to the urgency of the problem as well as to the question of the best solution.  Salk felt strongly that the immune system should be stimulated by a killed virus preparation, while Sabin was equally convinced that only the living virus could provide this need.  Each view had its own cadre of supporters and of opponents.

Funding issues also troubled those fighting the polio epidemics.  The March of Dimes is credited with raising a record $55 million in the fight against polio in early 1954, becoming the first major infectious disease battle to benefit from a concerted public awareness campaign and demonstrating the power of such volunteer driven efforts to supplement public and other private funding efforts.

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Summary:

This book combines social history with personal memoir. It serves as a reflection on how the various challenges of living with chronic illness have shifted over time, and how they are still real and present for the increasing portion of the population who suffer from ills invisible to others and often hard to account for.  The book's brief treatments of cultural and medical approaches to chronic illness, from ancient practices to "patients in the digital age," provide a broad perspective against which to consider current legislative, political, medical, and personal concerns for those coping with chronic illness or disability. 

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